Asia Drug Lockups Too Cruel, Ineffective to Earn U.S. Aid

By the Editors -
Aug 26, 2012

The accounts call to mind 18th
century insane asylums: patients confined against their will in
dismal conditions, abused and subjected to experiments and
unscientific treatments. Today’s inmates -- at least 350,000 --
are locked up, in China and Southeast Asia, just for using
illegal drugs, or being suspected of it.

Human Rights Watch recently released a paper detailing the
practice of warehousing alleged drug users in China, Cambodia,
Vietnam and Laos, adding to a stack of damning reports about
these centers, which also exist in Thailand and Malaysia. In
March, the United Nations Office on Drugs and Crime and 12 other
UN agencies called for closing all such institutions. It was a
noteworthy statement, given that the UNODC, as well as the U.S.
and other donor countries, has given many of them financial
support.

Dumped there by police or well-meaning but uninformed
families, detainees are sometimes held for years. Authorities
consider detention and grueling exercise to be treatment, though
there’s no evidence this is effective. Opiate addicts, whose
numbers are waning in Asia, get no opiate-substitution therapy.
No equivalent treatment exists for addiction to methamphetamine,
the use of which exploded in Asia in the late 1990s, prompting a
boom in detention camps. But existing, proven interventions,
such as individualized counseling, would help and aren’t made
available.

Former detainees have told human rights investigators about
being beaten with bricks and truncheons, subjected to medical
experiments, forced to crawl through excrement and swallow foul
water. A center staff member in China said female inmates were
HIV-tested so guards could identify whom they could rape without
a condom.

Forced labor is a feature in some countries. Sometimes it
is pointless, such as being made to repeatedly dig and fill
holes. Some centers in China and Vietnam amount to slave camps
because they produce goods -- notably processed cashews in
Vietnam -- using the labor of inmates, including children.

The U.S.,Japan, Sweden and the UNODC have actually helped
Laos build its centers. Countries including the U.S., Australia,
Canada, Luxembourg, Netherlands, Sweden and the U.K. have funded
programs within facilities throughout Southeast Asia to improve,
for instance, health care, vocational training or sports
facilities. They argue that at least they can make life better
for detainees.

This support just sustains a corrupt system. Even if these
institutions treated people well, they would still be based on
unlawful detention. And they utterly fail at their purpose. The
U.S. government estimates that 95 percent of released detainees
in Vietnam return to drug use. By contrast, in Australia, a
study found close to half the drug users who participated in a
two- or four-session program of motivational interviewing and
cognitive-behavioral therapy remained abstinent after six
months.

The call by UN agencies to close the Asian centers was a
good sign, though it would have been more reassuring had the
UNODC not co-sponsored a fashion show that same month to raise
funds for one such facility in Vientiane, the Laotian capital.

The UNODC, the U.S. and other donors would do well to
withhold relevant funding until the centers are closed,
detainees are released and local authorities agree to respect
international norms for treating drug abuse. These include
patient consent. Exceptions to that principle can be made only
rarely, for a short period, with judicial oversight, for the
purpose of restoring a patient’s ability to make decisions
autonomously. Treatment and rehabilitation services should be
offered within communities -- through health clinics or welfare
offices, for example -- so patients can access them easily and
without being stigmatized.

As a half-measure, some donors already support community-
based programs alongside the detention centers. Asking patients
to enter voluntary programs is risky, however, when their
identification as drug users might land them in a far worse
place. The drug-treatment system in China and Southeast Asia
can’t be reformed. It requires a do-over.